Episode 33: The Facial Injuries a Crash Can Leave Behind

SPEAKER_1 (0:02)

You're listening to Crashes, Claims, & Clarity, hosted by Darrell Burrow, a Georgia-based personal injury attorney with over 30 years of experience, and founder of Burrow & Associates. With a background in both legal strategy and compassionate client care, Darrell has helped over 10,000 individuals and families navigate life after injury.

Guided by his Christian faith and a deep sense of justice, he brings expert insight, personal stories, and powerful interviews to every episode. If you're looking for truth, support, and clarity in the aftermath of an accident, this is your place. This is Crashes, Claims, & Clarity.

Darrell Burrow (0:49)

Well, hello everyone and welcome to another episode of Crashes, Claims, & Clarity. I am your host Darrell Burrow, founding member of the law firm of Burrow & Associates. We're located right here in Duluth, Georgia in Gwinnett County, but servicing the entire state. Thank you for joining us today. I have the great pleasure of welcoming Dr. Aaron Fletcher. He's a board-certified, fellowship-trained otolaryngologist.

I'm sure he will correct me on that.

SPEAKER_1 (1:26)

I love that one. That was great.

Darrell Burrow (1:28)

Thank you. He is a facial plastic and reconstructive surgeon. He's the founder of the Georgia Center for ENT and Facial Plastic Surgery. That is a physician-owned practice right here in Atlanta, Georgia.

He treats conditions involving the ear, nose, throat, head, neck, including breathing problems, nasal injuries, facial trauma, and reconstructive concerns. He's also the author of the book, and I'll let you state that title for us, doctor.

Aaron Fletcher (2:04)

Copper Hexabotilaryngology Review.

Darrell Burrow (2:08)

Okay. Well, congratulations on your career accomplishments, your business that you founded, and certainly congratulations on all the people that you have helped over the course of your career.

Aaron Fletcher (2:24)

Sure. Thank you.

Darrell Burrow (2:26)

Appreciate you again joining me. I'm looking forward to learning a lot from you. I know your time is valuable. I'd like to jump right into some questions we have prepared for you, sir.

Aaron Fletcher (2:37)

Sounds good.

Darrell Burrow (2:39)

All right. So following a car crash, what facial or ENT injuries do you see that are most likely missed during an initial emergency room evaluation?

Aaron Fletcher (2:53)

Yeah, that's a great question. So it just so happens the most frequently broken bone in the body is the nasal bone. So most common thing I see after an accident is facial trauma, but most more specifically fractures of the nasal bones. And that's usually from a direct hit from either the airbag, a steering wheel, or the dashboard contact in the face. And nasal bones are prominently centered in the face. They're usually the first thing that gets hit when anything strikes the face.

And normally when you go in to the ER for an evaluation after a facial injury, they'll order a CAT scan, which is pretty good at picking up the bony injuries. But there can be injuries inside of the nose as well as inside of the ear that are not immediately visible and may not have obvious signs. So things like fractures of the nasal septum, hematomas inside the nose, bleeding inside the nose, some facial fractures which are hidden behind the soft tissue of the face. If there's not a laceration or bruising, a lot of times those areas get overlooked because they're hidden behind the skin and soft tissue of the face.

Darrell Burrow (4:04)

Okay.

A person, this goes hand in hand with the next question. A person may have no visible facial injury but later experience headaches, congestion, dizziness, hearing changes, possibly breathing difficulty. Which delayed symptoms like that would prompt or should prompt an evaluation by an ENT or facial trauma specialist?

Aaron Fletcher (4:30)

I would say any change in breathing. A lot of people, you know, when you get an acute injury, a lot of people are really shaken up. You've got adrenaline running. You may not notice initially that there are changes in your breathing, especially through the nose. But if you notice that one of your nostrils is blocked or obstructed if you're having trouble breathing on one side. If you notice any change in your hearing, you can have the inner ear structures be dislocated or concussed.

And sometimes the hearing loss doesn't manifest until days or weeks afterward. Any abrupt change in your sense of smell, which may indicate potentially a skull-based fracture or injury to the olfactory nerve, which is at the base of the skull right beneath the brain, where it's separated from the nasal cavity.

So yeah, loss of taste, any abrupt change in hearing, changes in breathing, leaking of fluid, especially clear fluid from the ear or the nose, could indicate a cerebral spinal fluid leak or a skull-based fracture, and also changes in the function of the face. You notice that one side of your face is not moving when you go to animate your face. That could indicate possibly a facial nerve injury, which can arise from fractures of the temporal bone, which also happen quite frequently with these type of accidents.